IOL exchange after YAG

I finally have an answer to the problem I've been having after cataract surgery in my left eye last February.  I do not have dysphototopsia.  The lens is slightly decentered and I am seeing the edge of the IOL.  I have been told that the surgery was good (the lens is in the bag), but it is so annoying and distracting because I am seeing the lens from 4 o'clock to about 11 o'clock and I see the edge quiver and pulse in and out.  One doctor told me that I needed laser surgery to correct an opacification (wrinkle) in the capsule and that maybe that would help with the visual problems I was having.  IT DID NOT.  Now I am stuck with this horrible problem unless I risk having the lens exchanged for a bigger one.  I understand that it is now more complicated because I had YAG.  How much more risky is it?  



This discussion is related to iol exchange pending.

[peakhope]

I'm no expert. I kept hearing about this YAG and wondered what it really was. I was picturing some laser process that would scrape the film off the inside of the lens bag or something.

Apparently what it really does is remove a huge chunk of the backside of the bag. If you picture your bag (after the original lens was removed) as a bean bag chair, the YAG is removing a circle of fabric the size of a garbage can lid.

After that, I would imagine that removing the IOL would be reasonably easy, but installing a new one seems like it would be extremely difficult.

That's the image in my head, anyway. I would be interested to hear from others if it's accurate.

[John C Hagan III, MD, FACS, FAAO]

Go to Google IMAGES  type in yag laser capsulotomy and you will see many figures and photos that will enable you to see the capsular BAG, the OPACIFICATION that develops and the hole that the yag laser creates. (cold laser).

Done by an experiences surgeon the IOL exchange is not a high risk procedure. (nothing is no risk in life and medicine). Most Eye MDs don't do many exchanges (thankfully not many are needed).

Most mid and large cities have a Eye MD that specializes in complicated re-operations. Ask your Eye MD for a referral (unless he/she does a lot of this type of work).

JCH MD